Nipple necrosis?! Day 10 after breast reduction. (Photo)

Question

Since day 1, my right nipple and areola have been purple. I'm trying to maintain a positive attitude but I am quite afraid that I'll have to go back under the knife. As of right now, I've been told to apply Polysporin 4 times a day to keep moist.

Anthony A. Admire, MD, FACS · Answer

It looks like you have more venous congestion than true nipple necrosis. Close f/u with your surgeon is a must. Some early treatment options can save that nipple such as releasing some sutures, using topical vasodilators, etc. Best of luck.

Brian E. Rosett, MD · Answer

Hey there.  From the pictures it would appear that you do not have necrosis of your nipple, especially if this is day 10.  Sometimes after a breast reduction, especially after a big reduction you can have some decreased blood flow to the nipple which can result in a spectrum of results from loss of the superficial skin layer to partial or complete nipple loss.  My guess is that you’re definitely towards the less servere aspect of that spectrum.  Keep putting the polysporin on and continue to follow up with your plastic surgeon.  There’s a chance that a small amount of superficial skin may fall off leaving young new skin under that.  If you were African American that skin is usually less dark but in caucasian patients its generally not significantly different in color.  If you do have some minor loss (which I really dont think you will have) it can be fixed in the office with some numbing medication and a few stitches.  It’s also important that you are not smoking to optimize healing.

Daniel Barrett, MD · Answer

Dear hr.family,it is hard to tell for sure without an examination. I would suggest you to consult your plastic surgeon. Only after a thorough examination you will get more information and recommendations. Make sure to follow his/her instructions.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Charles Durrant, MA, MBBS, FRCS(plast) · Answer

Hi,
Your nipple looks more bruised and congested than necrotic. My only concern at this stage is that your right breast looks significantly larger than your left (although this might just be the angle of the photograph). If there is a collection of blood in the breast then this might be compressing the pedicle that supplies the nipple with blood and could cause congestion. I would recommend close follow-up with your PS. good luck

Curtis Wong, MD · Answer

and you don't appear to have that by your photo.  If you have any refill and warmth, your nipple will be fine.  If cold and dark, then you could lose some of it but only time will tell.  There really isn't anything you can do at this point except to heal and then determine if any revisions or reconstructions will be needed.

Matthew H. Steele, MD · Answer

Thank you for our question and photo.  Sorry to hear about your complication after surgery.  From what I can see, you have bruising of the upper half of the areola.  By day 10, if you had necrosis, the area would be black, hard, and dry.  You may end up with some superficial skin loss, but I doubt you will lose your entire nipple.  Best to follow your surgeon’s wound care instructions.  Good luck.

Sanjay Mukerji, MD · Answer

It does appear darker compared to the other side. This can be because of pooled blood underneath it or compromised blood supply. The best thing to do is continue to have it be evaluated by your plastic surgeon, and see how much of it survives. 
Dr. Sanjay Mukerji
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Gary L. Ross, MBChB, FRCS · Answer

If at day 10 you press the nipple areola skin and hold it for a few seconds and let go and the blood returns after applying pressure it is likely that the nipple is fine. If the nipple is warm and you have sensation then again the nipple should be fine. You can get a different colour in each areola postop and if you have more bruising on one side often the areola can look more purple at this stage. Best to see your PS for reassurance though.

Frederic H. Corbin, MD (license restricted) · Answer

Sorry for your concerns but an examination is needed to make an accurate diagnosis so see your surgeonDr Corbin

Nipple necrosis?! Day 10 after breast reduction. (Photo)

Answers (9)

More Breast Reduction Questions

36G/H looking to reduce to 36 B/C - is a B cup too small?

What is the procedure if a patient self pays for breast reduction surgery vs. insurance coverage?

Alka Selzer before surgery: I took it November 4th my surgery is November 13th.

Breast reduction wound healing: it seems to be getting worse. (Photos)

This is a follow up to my last question about marijuana use before a breast reduction.

WE SEND PRETTY
EMAILS